Director, Case Management & Utilization

About Us

CarePoint Health is one of New Jersey’s leading health care systems comprised of three long-standing and highly-regarded hospitals Christ Hospital in Jersey City, Hoboken University Medical Center and Bayonne Medical Center.

CarePoint united three area hospitals to provide 360-degree-coordinated care by integrating the medical facilities and physician networks associated with these institutions.

With over 4,500 employees, CarePoint is the largest private employer in Hudson County, New Jersey and each year provides care to over 300,000 individuals.

CarePoint prides itself on its patient-focused approach to care delivery, with an emphasis on preventative medicine, health education, and disease management.

Leveraging its vast network of physicians and healthcare experts, CarePoint is quickly becoming recognized as a leader in the broader healthcare landscape as it pioneers creative solutions to address urgent population health needs.

What You'll Be Doing

The Director of Case Management & Utilization will be responsible for the strategic direction setting, management, continuous improvement, and maintenance of the Case Management / Utilization.

This role evaluates the efficiency, appropriateness, necessity of the use of medical services, procedures, and level of care for patients.

This position is empowered to review medical services with evidenced-based criteria that will be reviewed by payers. Develops and implements strategies to improve workflows and processes / procedures to enhance the utilization review program.

Works to ensure care is delivered to patients at University Hospital in appropriate time frames to maximize patient flow and reimbursement.

Ensures that discharge planning is thorough, patient-centered, and effective by fostering the concept of evidence-based practice and employing strategic interventions that assures that the care meets national, regional and University Hospital quality improvement standards.

Provides decision support to patients, families, and physicians managing patient and family expectations. Supports the mission of CarePoint Health.

What We're Looking For

Full Time, Day Shift

• Licensed as a Registered Nurse in the State of New Jersey.
• Bachelor’s Degree in Nursing required, Master’s Degree is preferred.
• Five (5) years of experience in an acute care setting required
• Two (2) years of experience in case management / utilization review / quality improvement leadership position required.
• Excellent interpersonal, communication skills. Must demonstrate a strong orientation to customer satisfaction, effective teamwork, problem solving and utilize small group dynamics in conflict management.
• Microsoft Office Suite proficiency required.
• Must possess leadership and management ability.

What We Offer

• Competitive pay
• Medical, dental, and vision insurance
• 401k with Company match
• Generous paid time off
• Paid Holidays
• Tuition Reimbursement
• Advancement and career development opportunities
30+ days ago